MR imaging-guided biliary drainage in an open low-field system: First clinical experiences

Purpose: To test the feasibility of MR imaging (MRI)-guided percutaneous bi liary drainages in patients using an open MR-system. Methods: 6 patients wi th mechanical cholestasis underwent MRI-guided puncture and catheterization of the biliary system following intervention planning with magnetic resona nce cholangiography (MRC) in an open low-field MR system. Data on the numbe r of punctures required, success in establishing external and internal drai nage, and total procedure time were compared to those of 6 patients who und erwent biliary drainage with fluoroscopic guidance. Results: MRC facilitate d intervention planning in all patients. Near-real-time MR imaging enabled interactive positioning of the devices. The bile ducts were punctured under MRI control in three patients in the first, in two in the second, and in o ne in the third attempt. MRI-guided puncture was faster than the fluoroscop ic procedure. Catheterization for external drainage was successful in all p atients. Passing the obstructions was not possible under MRI guidance. The procedure time for MRI-guided catheterization was longer than in the conven tional technique. Conclusion: MRI-guidance allows reliable placement of an external biliary drainage in an open low-field MR system.